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Preliminary report on a EUS guided pseudocyst drainage with a new lumen apposing metal stent (SPAXUS™); single center, 9 months experience
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Background and Aims
Endoscopic ultrasound (EUS)-guided drainage has become a mainstay for treating peripancreatic fluid collection and fully covered metal stent provided more efficient drainage than plastic stent. Recently, wide-flanged fully covered metal stent is introduced in EUS-guided pseudocyst drainage and showed promising results. The aim of this study was to evaluate the feasibility and efficacy of EUS-guided pseudocyst drainage with a new lumen apposing metal stent (Niti-S SPAXUS Stent; Taewoong Medical, Seoul, Korea).






Method
A prospective, single-arm, multicenter feasibility study of EUS-guide pseudocyst drainage with SPAXUS is now enrolling patients at 6 tertiary hospital in Korea. This preliminary report describes single center, 9 months experiences of the multicenter study. Between January and September 2016, a total of 11 patients were treated with EUS-guided pseudocyst drainage with SPAXUS in our institute. Baseline characteristics and outcomes including technical/clinical success rate, adverse event, and recurrence rate were evaluated.





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Result
The median age of 11 patients was 57 (42-76) and male was 10 of 11 patients. The median size of PFC was 80 mm (60-160 mm). SPAXUS was successfully placed all patients and PFC resolution was achieved in all 11 patients at median of 35 days after stent placement. The median procedure time was 7 min (5-10 min). Three cases of fever were developed during immediate post-procedure period and all of them were successfully treated with intravenous antibiotics. No other immediate post-procedure adverse events were seen. One case of stent occlusion was developed 40 days after procedure and endoscopic stent cleaning with retrieval balloon was conducted. Until now, no case of PFC recurrence was observed.











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Conclusion
EUS-guided pseudocyst drainage with SPAXUS was conducted effectively and safely in our institute until now. Further multicenter experience would be helpful to clarify the role of this procedure.









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